in the upper-right corner, or the New Message link in the Sent Messages/Received Messages section.1
• To compose a message from the Message Center tab:
a Click the Message Center tab.
b In the Messages menu, click Compose Message.
• To compose a message from a patient summary:
a Access a patient’s summary; for instructions, see Accessing a Patient Summary.
b While viewing the patient summary, click in the upper-right corner, or the New Message link in the Sent Messages/Received Messages section.
The patient is automatically referenced in the new clinical message.
2 To quickly search for internal and external Care360 Labs & Meds, ePrescribing, or EHR recipients, type the first three letters of the recipient’s name (first or last)in the To box, and then click the name of the recipient in the search results list that appears.
3 To specify Care360 Labs & Meds, ePrescribing, or EHR message recipients by selecting them from a list, click 
in the To box, and then do one of the following:
• Click the Internal tab. In the list of users within your organization, select the check box next to the appropriate recipient, and then click Add.
• Click the Search tab. Do the following:
a Type the search criteria for the recipient in the boxes, or click criteria in the lists, and then click Search.
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Note: The Specialty list can be used to narrow the results when searching for message recipients. You can manage the specialties for users within your organization using the Manage Specialities feature (if you are assigned the correct user role). For more information about managing specialties, see Managing Specialties. |
b In the list of search results, select the check box next to each appropriate recipient, and then click Add.
• Click the Last 20 tab. In the list of recent recipients, select the check box next to the appropriate recipient, and then click Add.
• Click the Practice tab. Do the following:
a Type the search criteria for the practice in the boxes, or click criteria in the lists, and then click Search.
Only practices which have the inbox feature enabled appear in the search results.
b In the list of search results, select the check box next to the appropriate practice(s), and then click Add.
The selected recipients appear in the To box. To remove a user or practice from the To box, click 
to the right of the appropriate name.
4 To send a message directly to a patient MyQuest™ account, select the Send to Patient Portal check box.
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Note: This option is only available for organizations that subscribe to Care360 EHR. In addition, you can only use this option to send messages to patients who have set up a MyQuest account and established a Patient Portal link with Care360 EHR. For more information, see Patient Portal Accounts. |
5 To quickly search for a Direct message recipient, type the first three letters of the recipient’s name (first or last) in the To Direct box, and then click the name of the recipient in the search results list that appears.
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Tip: If you typed in a recipient's Direct address, you can quickly add it to the Contacts list by clicking |
6 To specify Direct message recipients by selecting them from a list, click in the To Direct box, and then do any of the following:
• Click the Search tab. Do the following:
a Type the search criteria for the recipient in the boxes and then click Search.
b In the list of search results, select the check box next to each appropriate recipient, and then click Add.
• Click the Contacts tab. Do the following:
a Click a letter or the number sign to view favorite recipients beginning with the selected letter or numbers or characters. Click All to view all fax recipients.
b Select the line that contains the appropriate recipient and then click Add.
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Tip: Click Edit (next to the recipient's name) to edit the contact (name, Direct address, fax number, or organization name) or click |
• Click the Last 20 tab. In the list of recent recipients, select the check boxes next to each appropriate recipient and then click Add.
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Note: If your organization hasDirect Messaging or Direct Exchange, you can send and receive Direct messages. In addition, only users who have accepted the Direct messaging end user license agreement, and established a Direct Messaging or Direct Exchange address, can send or receive Direct messages. If you have a Direct Messaging address and a Direct Exchange address, the Direct Exchange address will be the default address used for new messages. For more information, see Creating a Direct Address. |
7 In the Subject box, type a brief subject
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• If the Please Select Date of Office Visit box appears, specify a date or click the calendar icon to select a date on which the office visit occurred.
• If the Please select date patient requested clinical summary box appears, specify a date or click the calendar icon to select the date on which the patient requested a clinical summary.
• If the Office Visit Date box appears, specify a date to identify the encounter note related to the office visit for which you are providing the patient with information.
• If the Referring Provider box appears, click the name of the provider who is currently responsible for the patient’s care.
9 To access the Attach Clinical Activities dialog box and attach a patient summary or clinical activities to the message, click the Add Attachments link.
If you do not want to attach clinical information, skip to step 12.
10 Do the following to select the patient whose data you want to reference in the message:
a In the Patient box, type the last name of the patient.
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Note: If the patient’s last name contains a space, you must include the space in your search text. For example, typing |
b In the list of results, click the appropriate patient.
If you only want to attach the patient’s identification to the clinical message, skip to step 11.
c If you do not have permission to share the specified patient’s clinical information, but need to attach clinical information for a specific situation such as a medical emergency, you can override the patient’s consent by doing the following:
i Select the Override this patient’s consent check box.
ii In the Authorizing Provider list, click the name of the provider who authorized the patient consent override.
iii In the Override Reason list, click the appropriate reason for the patient consent override.
If you select Other, then you must type comments (in the Other Reason box) to explain why you are overriding the patient consent.
The patient’s identification appears, as well as visit details specific to an encounter (if specified), all lab, diagnostic, or radiology results, all medications (including vaccines), all patient history, all clinical notes, all other documents, all active allergies/adverse reactions, and all active or resolved problems for the patient. An OB tab may also appear, which allows users to send the patient’s OB data or additional clinical data in an antepartum report.
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Note: The options and information available on this dialog box are dependent on your organization’s premium services and your reason for disclosure. Therefore, you may not see all the options described. |
11 Do the following to select patient data to attach to the clinical message:
• If the Meaningful Use Compliant Quick Select check box appears, select it to automatically attach a portion of the patient’s data. Attached data is as follows:
• If you selected the Referral or Transfer/Transition of Care Report disclosure reason, attached data now includes the last seven days of their labs (tests, results and values), the most recent clinical note (including vital signs, care plans, encounter diagnoses, cognitive status, functional status, and in office procedures) with a visit type of Visit with Provider, the most recent active smoking status, all active problems and allergies, all active and refused medications (including vaccinations) and the referring provider’s contact information.
• If you selected the Provide Patient with Office Visit Summary disclosure reason, attached data includes visit details for the specified office visit (reason for visit, vitals, in office procedures, plan of care, goals and instructions, patient clinical instructions, future scheduled appointments, education materials, referrals, pending diagnostics, and future scheduled tests), the most recent active smoking status, all active problems and allergies, all active medications, all active and refused vaccinations, and labs (tests, results and values) with a result date within seven days of the specified office visit.
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Caution! The Visit Details tab allows you to select specific items in the encounter note that you want to disclose to the patient, but if you also select the encounter note for this visit from the Clinical Notes tab, you also provide the patient with all information in the PDF version of the encounter note. |
• If the Quick Select check box appears, select it to automatically attach a portion of the patient’s data, including the last two years of their lab results, the last two years of their radiology results, all active problems and allergies, and all active, inactive, and refused medications (including vaccinations).
• If there is information that you do not want disclosed to the patient due to legal or medical reasons, do the following:
a Select the Information withheld due to potential harm to the patient check box.
b Type the reason why this information is not being disclosed in the Reason box.
c Clear the check box(es) next to the appropriate data on any of tabs (if you previously selected the Meaningful Use Compliant Quick Select or the Quick Select check box).
• On the Visit Details, Labs, Problems, Allergies, Medications, Radiology Results, Patient History, Diagnostics, Clinical Notes, OB or Other Documents tabs, select the check box next to each data item that you want to include in the message, or select the check box in the column heading to select all data items listed for the category. Some tabs support filtering, so you can browse only certain subsets of clinical data.
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Caution! If you have selected the Meaningful Use Compliant Quick Select check box, removing data items on any of these tabs can negatively impact your Meaningful Use metrics if you have not selected the Information withheld due to potential harm to the patient check box. |
If you have selected problems which either have a missing SNOMED code or have not been reviewed (indicated by 
), you will be reminded to review the problem and assign the appropriate SNOMED code. To do this, exit the Print Clinical Attachments dialog box, click Patient Visit > Problems, and then click the icon to review and verify the SNOMED codes and descriptions. When the Edit dialog box appears, make any necessary changes and then click Save.
• On the OB tab, select the Include Antepartum Package check box to include OB data or additional clinical data in an antepartum report for the patient, and then do the following:
a Enter a date range at Start and End.
The date range for an antepartum report cannot exceed one year.
b Select or clear the check boxes to indicate which clinical data to include in the report.
12 Click Attach Selected to attach the data to the message.
If the Problems Not Coded in SNOMED warning message appears, click Continue or Cancel, as appropriate.
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Note: To add more activities, click AddAttachments again. You can also click |
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Note: You can only add a letterhead to messages which reference a patient. If you have not referenced a patient, refer to step 10 (above). |
14 If available, click the calendar icon and select the date you want to display in the letterhead.
15 Type the message content.
16 Click Send.
• If an antepartum report is attached to the message, a copy of the report is automatically saved to the referenced patient’s summary as an uploaded document.
• Attached clinical data appears as it did when it was sent. Relevant template information is also included with history items. Updates made after the message is sent are not reflected in the attached clinical data.
• If you attached uploaded clinical activities to a message that includes a Direct recipient, you may receive a message indicating that the message and attachments exceed the size limit and will be split and sent as smaller individual messages. Each individual message will have the same subject as the original message that you created, as well as numbers identifying it as a set of related messages. For example, Patient Message (1 of 2) and Patient Message (2 of 2).
• If the recipient of your message is a Direct user, clinical attachments are sent in a Continuity of Care Document (CCD), or as a separate file referenced by the CCD. CCDs generated by Care360 EHR adhere to CCDA standards. Delivery of patient information using this architecture complies with Meaningful Use Stage 2 guidelines. For more information about CCDA CCDs, see Export Patient Data.
and then adding information about the contact in the Add Contact dialog box.
to remove the contact from your organization’s Contacts list. Contacts can also be managed from the Contacts list. For more information, see